Audiology 2013

Session Descriptions

These pre-recorded lectures are on-demand and last only an hour, so you can listen to them whenever time permits!

Opening Plenary

CAPD: Science, Practice, and the Auditory Footprint

Gail D. Chermak, PhD, CCC-A
Frank E. Musiek, PhD, CCC-A

This session introduces participants to the program lineup and presenters, and provides an overview of the history of central auditory processing disorder (CAPD). Participants will learn this field has its roots in the 1950s, with numerous U.S. conferences beginning in the 1970s, including the 2012 Global Conference in Boston and this ASHA online conference. They will be provided an overview of the science (neurobiology) and practice of CAPD (diagnosis and treatment) and they will be introduced to a new concept in CAPD—the auditory footprint.

Learning Outcomes
You will be able to:

• list major landmarks and individuals in the history of CAPD;
• describe the neurobiological underpinnings of CAPD;
• identify the basis for diagnosis of CAPD;
• describe how CAPD can be treated and managed;
• describe the influence of the auditory system on any acoustically presented materials.

Conference Sessions

APD Diagnosis: The Advantages and Limitations of APD Assessments

Piers Dawes, PhD

Auditory processing disorder (APD) is of interest because of potential causal links with learning disabilities and listening difficulties in children. However, APD is a controversial diagnosis and there are concerns over definition, diagnosis, the nature of the association with learning disabilities, and treatment. This talk will focus on APD diagnosis, with a review of APD rating scales (such as Fisher's Auditory Checklist and the Children's Auditory Performance Scale), behavioral tests (such as the SCAN test), and electrophysiological tests. Significant concerns of low reliability and validity of current diagnostic instruments and diagnostic methods are raised with examples from current research literature. Development of reliable measures is a priority for the field of APD research and clinical practice.

Learning Outcomes
You will be able to:

• list the three major types of APD assessments; i) behavior checklists, ii) electrophysiological measures and iii) behavioral tests;
• describe the advantages and limitations of each assessment;
• identify general limitations of APD assessment and describe directions for development of future methods of APD assessment.

Auditory and Cognitive Aging and CAPD

Kathy Pichora-Fuller, PhD

There are declines in both auditory and cognitive processing as adults age. Importantly, strong connections exist between auditory and cognitive functioning in healthy older adults and in those with clinically significant impairments. In combination, these declines contribute to problems communicating in everyday life. Difficulties understanding speech in noise may bother even older adults who have good audiograms. On a more positive note, new knowledge regarding brain plasticity suggests that auditory and cognitive abilities that are preserved can be harnessed to compensate for some age-related declines as people re-learn how to listen. New approaches to audiologic rehabilitation and health promotion for older adults should be guided by integrating knowledge about auditory and cognitive aging and adopting a functional approach to address their communication problems.

Learning Outcomes
You will be able to:

• explain why older adults have trouble listening in noise even when they have good audiograms;
• explain that hearing loss can exacerbate declines in cognitive performance and increase risk of incident dementia;
• describe approaches to rehabilitation for older adults that consider auditory and cognitive aging.

Auditory Interventions for Children with Auditory Processing Disorders

Mridula Sharma, PhD

The presentation will provide evidence for interventions that are currently available within the field of auditory processing disorders. The International Classification of Functioning, Disability, and Health (ICF) framework will be put forth that may assist audiologists in planning their diagnostic and management strategies within their practice.

Learning Outcomes
You will be able to:

• summarize the evidence that is currently available in literature regarding the management of auditory processing disorders;
• identify the role of auditory, language, and FM in management of auditory processing disorders;
• describe the role ICF model can play in the overall clinical diagnosis and management of APD across ages.

Auditory Training in Older Adults

Nina Kraus, PhD

As we age, we begin to lose our proficiency in listening in noise, processing, and memory. However, there are short-term and long-term steps that can be taken to forestall these declines. In this presentation I will discuss the "cognitive auditory system," highlighting that hearing and communication skills are greatly affected by the exercise of skills such as attention and memory. In particular, I will focus on the musician's brain and evidence that playing an instrument has life-long benefits to communication skills. However, older adults who are not musicians do not have to be left behind. There is evidence that software-based "brain training" programs can have a beneficial effect after only a few months. I will review studies that demonstrate both of these experiential/training approaches, and discuss the neurophysiological methodology we used to examine the physiological changes that underlie the communication improvements they brought about.

Learning Outcomes
You will be able to:

• explain that the malleability of the brain extends well into adulthood and that this has consequences for communication training;
• describe the role that cognitive processes contribute to hearing;
• identify the characteristics of the brainstem response to complex sounds that make it an appropriate evaluation of central auditory processes and their response to experience and training.

CAPD Diagnosis With the Test-Battery Approach

Jeff Weihing, PhD, CCC-A

The test battery approach to assessment of CAPD is generally utilized because no single test can measure all auditory processes thought to benefit listening. The decision to adopt this approach to assessment raises questions of how tests should be selected for CAPD batteries. The present talk will cover the merits of the test battery approach and consider how existing research literature can help audiologists in constructing a sensitive and specific test battery. Using the test battery approach brings pros and cons to the clinical assessment of CAPD, and these features will both be considered in turn.

Learning Outcomes
You will be able to:

• describe why test batteries are used in CAPD assessment;
• identify sensitive and specific test batteries;
• explain the strengths and weaknesses of the test battery approach.

Computer-Based Auditory Training

Linda Thibodeau, PhD, CCC-A/SLP

Auditory training can strengthen auditory processing skills. Computer based auditory training is especially useful because it can often be completed in the home environment which increases the frequency of training. Online speech-in-noise tests can be used to establish baseline performance and monitor progress. A review of computer based auditory training programs for school-age children will be provided with suggestions for interfacing with assistive technology.

Learning Outcomes
You will be able to:

• identify four basic levels of auditory training and ways to increase the difficulty of each task;
• list the benefits of auditory training via computers compared to individual therapy;
• describe four commercially-available computer-based auditory training programs;
• assess the benefits of a computer-based auditory training program for a school-age child.

Developmental and Neuropsychiatric Disorders and CAPD

Vasiliki (Vivian) Maria Iliadou, PhD

New scientific data are emerging showing deficits in the processing of auditory information in neuropsychiatric and developmental disorders such as schizophrenia, bipolar disorder, Alzheimer's disease, autistic spectrum, and dyslexia. As cognitive deficits are usually present in these disorders, the question arising is how can one interpret the co-existing deficits of central auditory processing and cognition including attention and memory issues. This interpretation is not straightforward, as possibilities of correlation are numerous. While the exact correlation between central auditory processing deficits and cognitive ones is the subject of debate, it is still important to document the presence of central auditory processing disorders in developmental and neuropsychiatric disorders. Knowing that CAPD is present can have an impact on management with the additional possibility of improving cognition as well. CAPD may interfere with prosody
perception resulting in deficits in the everyday communication abilities.

Learning Outcomes
You will be able to:

• describe current research data on comorbidity of central auditory processing disorders with developmental and neuropsychiatric disorders;
• describe how to handle clients with these disorders or those who exhibit symptoms related to developmental and neuropsychiatric disorders.

Differential Diagnosis of CAPD and ADHD

Teri Bellis, PhD, CCC-A, FAAA, F-ASHA

Central Auditory Processing Disorder (CAPD) and Attention Deficit/Hyperactivity Disorder (ADHD) frequently co-exist and/or are confused with one another due to overlap in some symptomatology. The ability to differentiate between the two disorders, as well as to identify when they may co-exist within an individual, is critical for appropriate intervention. The purpose of this session is to assist SLPs, audiologists, and other interested professionals in understanding both the definitions of CAPD and ADHD as well as the neurobiological underpinnings supporting the frequent co-morbidity of the two disorders. Particular focus will be placed on methods of differentially diagnosing CAPD and ADHD. Recent data regarding the importance of analysis of inter- and intra-test patterns of performance on tests of central auditory function in the differentiation between CAPD and ADHD will be presented.

Learning Outcomes
You will be able to:

• compare and contrast the definitions and neurobiological foundations of CAPD and ADHD;
• discuss methods of diagnosing CAPD and ADHD;
• discuss the importance of inter- and intra-test pattern analysis of performance on central auditory tests for differential diagnosis purposes.

Disorders of the Auditory Brain

Timothy D. Griffiths, FMedSci

This session will provide a primer on the function of the normal auditory system, particularly about the emerging understanding of how the auditory cortex functions. This will be related to disorders that affect this system, including tinnitus, musical hallucinations, acquired central deafness, acquired auditory agnosia, and congenital auditory agnosia.

Learning Outcomes
You will be able to:

• identify the brain basis for the most common disorders of the auditory brain;
• detail a specific multidisciplinary approach to such disorders of the auditory brain developed with colleagues in neurotology;
• describe disorders of central auditory analysis where the lesion is well established;
• apply the method in a similar way to disorders of central auditory analysis, such as auditory processing disorder (APD), where the lesion is not well established.

How Music Training Impacts Brain and Cognitive Development

Dana Strait, PhD

This talk will present evidence for neurobiological effects of music training on speech-sound processing in children and adults, ages 3–35. Specifically, we reveal that musicians' perceptual, cognitive, and neural enhancements are observable early in life, during the years in which the auditory system is under rapid development. While musically-trained children as young as age three demonstrate neural speech-sound processing advantages, the broadest perceptual, cognitive, and neurophysiologic advantages are observed in school-aged child musicians.

Implications for clinical strategies will be discussed, with attention given to the role of music in clinical and educational practice. Final concerns will address neurodevelopmental impairments in children with language-based learning deficiencies and their potential to gain remedial benefits from music training.

Learning Outcomes
You will be able to:

• describe three ways that music training shapes brain development;
• describe two similarities and two differences between preschool- and school-aged child musicians' neural enhancements;
• describe five brain and/or cognitive enhancements in child musicians that overlap with deficiencies in children with language-based learning disorders.

School-Based Services for Students with CAPD

Georgina Lynch, MS, CCC-SLP

Determining appropriate educational services for students with CAPD can be a difficult process when it comes to meeting special education eligibility criteria and when developing an Individualized Education Program (IEP). Frequently there can be disagreement over what services are needed, if at all, and how to provide them. Establishing appropriate services for CAPD following existing federal regulations, and determining what may be considered "appropriate," requires a collaborative approach capitalizing on the skills of the educational audiologist and the speech-language pathologist. Explore the use of compensatory strategies and direct intervention techniques for CAPD as developed following federal requirements and a framework related to IEP's and 504 plans. A relatively new direction for intervention services outlined by a "Response to Intervention" (RTI) model within the educational system has begun to offer more access to services for students with CAPD at an earlier stage post-diagnosis. Participants will receive current information related to federal guidelines governing provision of services as they relate to CAPD, including the shift in intervention design following RTI. An overview of how to identify areas of need, specific interventions to consider, and the use of collaborative planning within the educational system will be discussed.

Learning Outcomes
You will be able to:

• explain how special education services are established within the public education system under federal rules and regulations;
• identify interventions commonly used to assist students with CAPD in the public school setting, including direct treatment and compensatory strategies;
• define the roles of the educational audiologist and the speech-language pathologist in providing support services for CAPD within the educational setting;
• identify and explain the difference between the terms "accommodations" and "specially designed instruction;"
• distinguish the types of services appropriate for CAPD under the provision of an IEP vs. a 504 Plan;
• understand options available to students following a Response to Intervention model of intervention service delivery, ensuring intervention services are provided at an earlier stage post-diagnosis.

Underlying Causes of CAPD in Children

Mirela Boscariol, PhD

Participants will learn about possible causes that can lead to language-learning impairment (LLI) and central auditory processing disorders (CAPD) in children and the importance of an interdisciplinary treatment team. They should have a better understanding of the relationship between clinical evaluation and neuroimaging, such as using magnetic resonance imaging (MRI) in determining underlying causes of LLI and CAPD. Understanding the subtle structural changes in cortical development may aid the diagnosis and therapeutic prognosis of many learning problems, so that the treatment of these children may be tailored using a more reliable diagnosis.

Learning Outcomes
You will be able to:

• correlate the literature with the practice underlying causes of language-learning impairment and central auditory processing disorders;
• use scientific evidence to define the research question and hypothesis, critical evaluation and decision-making based on acquired knowledge.

Using Technology to Improve Auditory-Based Learning Deficit Outcomes

Jane Hornickel, PhD

Approximately 10% of school-aged children are affected by a language-based learning disorder, and many students, even typically-developing children, are impacted by the sometimes poor auditory environment of their classrooms. Recent research by the Auditory Neuroscience Lab and others has shown neural processing of sound is predictive of communication skills such as reading and speech-in-noise perception. Although differences in brain function are found for poor readers and poor speech-in-noise listeners, auditory training can alter neural function in a beneficial way. This lecture will review technology-based training for children with auditory-based communication disorders, with a particular focus on classroom-based interventions, and discuss the potential mechanisms behind neural and behavioral changes seen with training.

Learning Outcomes
You will be able to:

• identify objective tools that may be useful in the diagnosis of CAPDs;
• analyze overlapping relationships among CAPDs, reading disability, and language impairment;
• identify intervention technology that can impact neural and behavioral function;
• discuss theories of the mechanisms behind training related change.